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Psychological factors mediate key symptoms of fibromyalgia through their influence on stress

Clinical Rheumatology volume 35, pages 2353–2357 (2016)Cite this article

Abstract

The clinical features of fibromyalgia are associated with various psychological factors, including stress. We examined the hypothesis that the path that psychological factors follow in influencing fibromyalgia symptoms is through their direct effect on stress. Ninety-eight females with ACR 1990 classified fibromyalgia completed the following questionnaires: The Big 5 Personality Inventory, Fibromyalgia Impact Questionnaire, Perceived Stress Scale, Profile of Mood States, Mastery Scale, and Perceived Control of Internal States Scale. SPSS (PASW version 22) was used to perform basic t tests, means, and standard deviations to show difference between symptom characteristics. Pathway analysis using structural equation modelling (Laavan) examined the effect of stress on the relationships between psychological factors and the elements that define the fibromyalgia phenotype. The preferred model showed that the identified path clearly linked the psychological variables of anxiety, neuroticism and mastery, but not internal control, to the three key elements of fibromyalgia, namely pain, fatigue and sleep (p < 0.001), via the person’s perceived stress. Confusion, however, did not fit the preferred model. This study confirms that stress is a necessary link in the pathway between certain identified, established and significant psychological factors and key fibromyalgia symptoms. This has implications for the understanding of contributing mechanisms and the clinical care of patients with fibromyalgia.

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References

  1. Kivimaki M, Leino-Arjas P, Virtanen M, Elovainio M, Keltikangas-Jarvinen L, Puttonen S et al (2004) Work stress and incidence of newly diagnosed fibromyalgia: prospective cohort study. J Psychosom Res 57(5):417–22

    PubMed  Google Scholar 

  2. Malin K, Littlejohn GO (2013) Stress modulates key psychological processes and characteristic symptoms in females with fibromyalgia. Clin Exp Rheumatol 31(6 Suppl 79):S64–71

    PubMed  Google Scholar 

  3. Hassett AL, Clauw DJ (2011) Does psychological stress cause chronic pain? Psychiatr Clin North Am 34(3):579–94

    Article  PubMed  Google Scholar 

  4. Van Houdenhove B (2005) Premorbid “overactive” lifestyle and stress-related pain/fatigue syndromes. J Psychosom Res 58(4):389–90

    Article  PubMed  Google Scholar 

  5. Low LA, Schweinhardt P (2012) Early life adversity as a risk factor for fibromyalgia in later life. Pain Res Treat 2012:1–15

  6. Gupta A, Silman AJ (2004) Psychological stress and fibromyalgia: a review of the evidence suggesting a neuroendocrine link. Arthritis Res Ther 6(3):98–106

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Thieme K, Turk DC (2012) Cognitive-behavioral and operant-behavioral therapy for people with fibromyalgia. Reumatismo 64(4):275–85

    Article  CAS  PubMed  Google Scholar 

  8. Thieme K, Turk DC, Gracely R, Maxiner W, Flor H (2015) The relationship among psychological and psychophysiological characteristics of fibromyalgia patients. J Pain 16(2):186–96

    Article  PubMed  Google Scholar 

  9. Malin K, Littlejohn G (2012) Psychological control is a key modulator of fibromyalgia symptoms and comorbidities. J Pain Res 5:463–71

    PubMed  PubMed Central  Google Scholar 

  10. Malin K, Littlejohn G (2012) Neuroticism in young women with fibromyalgia links to key clinical features. Pain Res Treat 10:1–7

  11. Malin K, Littlejohn G (2014) Psychological fibromyalgianess exists on a continuous spectrum. Austin J Orthop Rheumatol 1(1):1–7

    Article  Google Scholar 

  12. Malin K, Littlejohn G (2015) Rumination modulates stress and other psychological processes in fibromyalgia. Eur J Rheumatol 4:143–8

    Article  Google Scholar 

  13. Wolfe F (1989) Fibromyalgia: the clinical syndrome. Rheum Dis Clin North Am 15(1):1–18

    CAS  PubMed  Google Scholar 

  14. Wolfe F, Smythe HA, Yunus MB, Bennett RM, Bombardier C, Goldenberg DL et al (1990) The American College of Rheumatology 1990 criteria for the classification of fibromyalgia. Report of the Multicenter Criteria Committee. Arthritis Rheum 33(2):160–72

    Article  CAS  PubMed  Google Scholar 

  15. John OP, Robins RW, Pervin LA (1999) The big five personality inventory. In: Pervin LA, John O (eds) Handbook of Personality: Theory and Research. Guilford, New York, pp 103–138

  16. Burckhardt CS, Clark SR, Bennett RM (1991) The fibromyalgia impact questionnaire: development and validation. J Rheumatol 18(5):728–33

    CAS  PubMed  Google Scholar 

  17. Cohen S, Kamararck TRM (1983) A global measure of perceived stress. J Health Soc Behav 2:385–96

    Article  Google Scholar 

  18. McNair D, Lorr M, Droppleman LF (1992) Manual for the profile of mood states. Educational and Industrial Testing Service, San Diego, C.A

    Google Scholar 

  19. Pallant J (2000) Development and validation of a scale to measure perceived control of internal states. J Pers Assess 2:308–37

    Article  Google Scholar 

  20. Pearlin L, Schooler C (1978) The structure of coping. J Health Soc Behav 19:2–21

    Article  CAS  PubMed  Google Scholar 

  21. Rosseel Y (2012) Lavaan an R package for structural equation modeling. J Stat Softw 48(2):1–36

    Article  Google Scholar 

  22. Yanuar F, Ibrahim K, Jemain A (2010) On the application of structural equation modelling for the contrast of a health index. Environ Health Perv Med 15:285–91

    Article  Google Scholar 

  23. Boyer AL, Mira Pastor MA, Calatayud NP, Lopez-Roig S, Cantero Terol MC (2009) Comparing fibromyalgia patients from primary care and rheumatology settings: clinical and psychosocial features. Rheumatol Int 29(10):1151–60

    Article  PubMed  Google Scholar 

  24. Walen HR, Cronan PA, Bigatti SM (2001) Factors associated with healthcare costs in women with fibromyalgia. Am J Manag Care 7:Spec No:SP39-47

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Medicine, Monash University, Melbourne, Australia

    Katrina Malin & Geoffrey Owen Littlejohn

  2. Monash Medical Centre, Monash University, Level 5, Block E, 246 Clayton Road, Clayton, Victoria, 3168, Australia

    Katrina Malin

Authors
  1. Katrina Malin
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  2. Geoffrey Owen Littlejohn
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Correspondence to Katrina Malin.

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Malin, K., Littlejohn, G.O. Psychological factors mediate key symptoms of fibromyalgia through their influence on stress. Clin Rheumatol 35, 2353–2357 (2016). https://doi.org/10.1007/s10067-016-3315-9

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  • DOI: https://doi.org/10.1007/s10067-016-3315-9

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